An individual diagnosed with acute stress disorder disorder needs to meet all of the following criteria:
Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
Directly experiencing the traumatic event(s).
Witnessing, in person, the event(s) as it occurred to others.
Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: This does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred:
Intrusion Symptoms
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children, there may be frightening dreams without recognizable content.
Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
Negative Mood
Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
Dissociative Symptoms
An altered sense of the reality of one's surroundings or oneself (e.g., seeing oneself from another's perspective, being in a daze, time slowing).
Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol or drugs).
Avoidance Symptoms
Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Arousal Symptoms
Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
Hypervigilance.
Problems with concentration.
Exaggerated startle response.
Duration of the disturbance is 3 days to 1 month after trauma exposure. Note: Symptoms typically begin immediately after the trauma, but persistence for at least 3 days and up to a month is needed to meet disorder criteria.
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition (e.g., mild traumatic brain injury) and is not better explained by brief psychotic disorder.
This disorder develops in an otherwise mentally healthy individual in response to an exceptionally traumatic event. Initially there is a dissociative phase (with absence of emotional responsiveness, "being in a daze", derealization, depersonalization, and/or dissociative amnesia). Later the traumatic event is persistently reexperienced (flashbacks), or there is distress on exposure to reminders of the traumatic event. There is marked avoidance of stimuli that arouse recollections of the trauma. There are marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness). This disorder causes significant distress or life impairment. Symptoms typically begin immediately after the trauma, but persistence for at least 3 days and up to a month. It is not due to a drug, medication, or general medical condition.
Effective therapies
Prolonged exposure therapy is the most effective therapy (47% achieve full remission on 6 month followup). Trauma-focused cognitive behavioral therapy is far less effective (only 13% achieve full remission on 6 month followup). Supportive therapy is also less effective.
Ineffective therapies
Vitamins, dietary supplements, antidepressant, antianxiety, and antipsychotic medications are ineffective for this disorder.
Tiada ulasan:
Catat Ulasan